前节OCT测量激光虹膜根切术后前房角变化的研究

Changes of anterior chamber angle after laser peripheral iridectomy measured by slit lamp optical coherence tomography

目的研究激光虹膜根切术后房角的变化。方法选取诊断为可疑原发性房角关闭(PACS)及原发性房角关闭(PAC)患者13名(15眼),使用前节裂隙灯式光学相干断层扫描仪(OCT)在虹膜激光术前后进行眼前节的测量,比较房角开放距离(AOD)、小梁下-虹膜空间面积(TISA)和750μm房角角度(ACA 750)等监测指标。结果除前房深度外,各项检测指标在术后10 min、1 h及1 d均较术前有明显差异(P<0.01),而术后各时间段指标互相间无明显差异(P>0.05)。结论在可疑原发性房角关闭及原发性房角关闭患者,激光虹膜周切术后,前、后房压力恢复平衡,房角增宽,解除了瞳孔阻滞,从而可以防止房角进一步发生关闭,对闭角型青光眼的预防是一种安全而有效的方法。

Objective To study the changes of anterior chamber angle after laser peripheral iridectomy by slit lamp optical coherence tomography（SL-OCT）.Methods 13 patients（15 eyes） diagnosed as primary angle closure suspect（PACS） or primary angle closure（PAC） were included in this study.Angle opening distance（AOD）,trabecular-iris space area（TISA）,750-μm anterior chamber angle（ACA 750） and anterior chamber depth（ACD） were measured by SL-OCT.Results Compared with pre-operation,AOD,ACA 750 and TISA 10 min,1 h and 1 d after operation were all significantly different（P0.01） except ACD.No significant differences of above indexes were found among three postoperative time points.Conclusion The pressure between anterior and posterior chamber is balanced,and anterior chamber angle becomes wide in PACS and PAC patients after laser peripheral iridectomy.These changes can remove pupil block and further prevent chamber angle closing.Laser peripheral iridectomy is a safe and effective method for the prevention of angle closure glaucoma.